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Panel: Health care reform could create access problems

Medical College of Georgia President Dr. Ricardo Azziz (second from right) speaks at a health forum at Augusta State University.

While health care reform could result in things such as more preventive care, the influx of people to private and public programs could create serious access issues, a panel of experts said Thursday.

While there might be short-term problems, the long-term result might be better quality at less cost, some said.

In a forum organized by Augusta State University Hull College of Business, a panel of hospital executives, physicians and insurance providers debated the merits of the Patient Protection and Affordable Care Act passed earlier this year.

For instance, the act increases Medicaid eligibility that will result in an estimated 550,000 more people being added to the rolls in 2014. That will increase to 650,000 by 2020, said Dr. Jerry Dubberly, the chief of the Medicaid Division in the Georgia Department of Community Health. While the federal government will initially cover 90 percent of the additional cost of the increased enrollment, it will result in about $2.5 billion in additional state expenditures.

"That number is staggering," Dubberly said.

Medicare and Medicaid already do not meet the costs of providing care, which can mean a shifting of costs onto private insurers who would pay about 30 percent more, said Christopher Champlain, an individual sales representative for Blue Cross and Blue Shield of Georgia.

"The private sector essentially funds the public sector," he said.

Should reimbursements change drastically, that could impact access to care in the private sector, said Medical College of Georgia President Ricardo Azziz.

"Physicians will vote with their feet," he said.

This could be compounded by an expected shortage of 60,000 physicians by 2015, said Dr. Stanley Smith, an internal medicine and diabetes specialist with University Medical Associates of Augusta.

"You've got a huge demand and a very small supply," he said.

The onus will be on hospitals and physicians to find new ways to do business, particularly when there will be more public measures of quality of care for comparison, said C. Shayne George, the CEO of Doctors Hospital.

"We're going to have to provide more care with less reimbursement," he said. The key will be partnering and aligning with physicians and with other providers, George said.

"Complete networks that are aligned, with the physicians and the hospitals working together to improve outcomes of care and reduce costs, that's definitely going to be a big, big portion of this," he said.

The end result of this could ultimately be better health when the care is delivered, and the health care systems will have to find innovative new ways to do business, Azziz said.

"At the end of the day, these are our citizens and our community," he said.

Health care accounts for 24.5 percent of employment in the Augusta area, which is above the state and national average, said Dr. Simon Medcalfe, an assistant professor of finance at ASU.

"Whatever the impact is, it's going to be magnified here in Augusta because of the outsized presence of health care in the local economy," he said.